1. Field of the Invention
Each year multi-unit, division or subsidiary companies, corporations, partnerships, trusts, governments, employers, and other employer entities (hereinafter, ‘company or companies’) that utilize workers' compensation insurance to cover injuries to employees pay millions of dollars in avoidable Workers' Compensation costs and lost employee productivity due to lack of information, lack of standardized processes to analyze and manage the losses, absence of transitional duty programs to return workers to productive positions, unrecognized fraudulent claims, the amount of time required to implement and train company staff to manage the myriad elements of a successful cost reduction program for multiple units frequently in diverse locations. Generally, Workers' Compensation costs for companies with multiple units can be reduced by 20%-50% with the implementation of an efficient and effective multi-unit Workers' Compensation Management Program. Yet most companies do not have the knowledge and resources in-house to do so, and hiring consultants to review and train staff is very expensive.
The methods of the present invention provides an online centralized source to implement, analyze and manage a workers' compensation management program by a company across multiple company units. In addition, the methods provide scalability of resources thus enabling management to implement a customized program across multiple company units by utilizing the benchmarking and assessment methods of the present invention through the online centralized source.
A computer based online Workers' Compensation Management and Quality Control cost containment system for an employer with multiple company units is provided in the present invention and implemented in a preferred embodiment on the world wide web at workerscompkit.com. This improved method provides users, such as employers, self-insured companies, and third party claims administrators (TPA), the necessary tools to self-implement and manage a workers' compensation cost containment program, or have a third party (TPA) manage the program, as is common in the industry for an employer with multiple company units.
An advantage of the present invention for a company with a multi-unit workers' compensation program is that an off-site company risk manager can use the centralized web enabled methods of the present invention to monitor and manage adherence to company guidelines, which thus provides remote but real time quality control over multiple units simultaneously by the company management that was never before possible.
To ensure successful implementation, the website provides a centralized location for all users to access the company workers' compensation program background information, assessment tools, data benchmarks, customized recommendations, step-by-step improvement plans, and any other improved program functionality.
The improved assessment methods of the present invention provide for each unit of a company with multiple units, a plurality of company units, or the company as a whole, (1) a National Workers' Compensation Management Score®, (2) a National Workers' Compensation Management Score Tracker™, (3) Customized Recommendations for Improvement by Module for Multi-site Companies, (4) a Prioritized Action Plan, (5) individual unit National Workers' Compensation Management Score® Ranking, Best-to-Worst and Worst-to-Best, for individual units and (6) collectively for the company an Average National Workers' Compensation Management Score®; (7) a Best Practice Profile Ranking Report, (8) a Best Practices Gap Analysis, and (9) include the necessary training tools for the user.
The improved data benchmarking methods of the present invention provide for each unit of a company with multiple units, a plurality of company units, or the company as a whole, (1) comparisons of one or more units, or the company as a whole, to one or more industry groups, (2) comparisons of one or more units, or the company as a whole, to one or more states or government entities for which statistics are available, (3) a Return To Work Ratio Report, (4) a Return to Work Tracker, (5) a Transitional Duty Cost Calculator, and an (6) Impact to Business, or Gross Sales to Pay for Workers' Compensation Costs Calculator, and (7) include the necessary training tools for the user.
Thus the improvements to the comprehensive online website provide company management with methods of the present invention for analysis and quality control of the employer's operational best practices from inception through implementation and training simultaneously across multiple company units.
2. Description of Related Art
Various attempts have been made to develop ways to deliver workers' compensation management services. A common method still in extensive use is to have a consultant travel to the employer and spend many days observing employment and management worksite practices, taking and recording notes, and then returning to their office to compile those notes into a massive report. The report would then go back and forth for revisions until the assessment report was perfect. This process would take approximately nine to twelve months just to get to implementation of any recommendations with the project often stalling at the assessment phase with the threat of actual implementation being weakened because the project had lost momentum, run out of money, or business decisions changed the focus because so much time had elapsed. Too much time was spent on assessment taking the focus off the real purpose which was to identify strengths and weaknesses in the program and build an action plan to create a strong workers' compensation management program. Instead, the focus was on providing the client with a perfect report within a limited budget.
Co-pending U.S. patent application Ser. No. 11/839,483, filed Aug. 15, 2007, and published Feb. 21, 2008 as Pub. No. 2008/0046297, disclosed methods of workers' compensation program management and quality control by providing single source, up-to-date comparative standards and statistics integrated into a workers' compensation program management system that is self-implemented via a proprietary network computer user interface application accessible from any network enabled workstation. In one embodiment, the method of '483 comprises (a) using the memory of a computer to store data about a specific unit's workers' compensation practices, (b) then using a resident computer program to analyze the data to produce improvement recommendations for that specific unit, (c) have that unit implement the recommendations, and (d) repeat the first three steps as needed. That method overcame the limitations of the related art in that the necessary data needed to manage a single unit workers' compensation program, identify problems and formulate solutions, was centrally controlled and accessible at one source via a network connection.
While the method of '483 is successful in reducing workers' compensation costs for an individual unit, it did not address the needs of companies with more than one unit or location with the improvements disclosed herein. The improvements of the present invention to the methods as described herein enable multi-site companies to compare and monitor program compliance across a plurality of units simultaneously from one central application. For example, by the method of the present invention a franchisor with fifty franchisees can have all fifty franchisees participate in individual assessment analyses and data benchmarking. The franchisor would receive reports and capabilities by the improved benchmarking and assessment methods of the present invention (1) for each franchisee, (2) a plurality or specific group of franchisees, such as those in a specific geographical location, (3) or the entire franchisee group or company as a whole.
A system for optimizing a workers' compensation claims management process was disclosed in Colburn et al., U.S.P. A.P. 2001/0044735. The invention related generally to an insurance auditing and monitoring system, and more particularly to a system for auditing and monitoring workers' compensation claims. Colburn disclosed a two-tiered method of third party auditing of workers' compensation claims management procedures by adjusters. It is, very simply, a claims auditing system of adjuster performance by a third party. Colburn monitors open claims making sure the claims adjusters are following aggressive claims management techniques—on a per claim basis and a per adjuster basis. By comparison, the methods of the present invention are implemented by the management of the company whereas in Colburn the method is implemented by adjusters. The method of the present invention assesses a plurality of operating practices of the organization by means of an intake questionnaire. The methods of the present invention do not evaluate individual claims like Colburn. (emphasis added)
An automated method for monitoring individual workers' compensation claims was disclosed in Skedsvold, USPAP 2008/0154672. The system documented a plurality of predetermined event flows of a claim which defined the events necessary in the workers' compensation process. Each event then identified a participant in the process which would have to act to complete the event. The event also identified the required data, or approval, required to complete the event, and to be supplied by the participant. The system monitored, displayed, and stored the status of each event within the workers' compensation case and denoted the completion of the event. Thus, Skedsvold disclosed only a large diary tickler system for individual claims management based upon Georgia time frames. There is absolutely no suggestion in Skedsvold of the methods of the present invention for workers' compensation management practices of a company.
The software application described at www.comperaser.com is a claims management software application focusing on pre-loss (safety) training and claims management. In comparison to the methods of the present invention it does not contain the Best Practice Assessment, the National Workers' Compensation Management Score® or Score Tracker, the Customized Recommendations for Improvement, or Recommendations for Improvement by Module.
Similarly, the referenced patent application Uninsured Cost Estimation System and Method, Pub. No. 2007/0021985, is limited to a processing system for measuring uninsured costs.
The Institute of Workers' Compensation Advisors, www.workcomp-professionals.com, trains and certifies professional insurance agents to help companies identify and fight overcharges caused by mistakes rampant in the complex and confusing Workers' Compensation system. It does not provide the methods of the present invention.
CompEraser.com and the Institute of WorkComp Advisors, LLC, P.O. Box 5437, Asheville, N.C. 28813, are trying to lower workers comp costs but these programs do not contain an automated, standardized assessment scoring system based on company best practices. Neither do they contain complete on-line training programs nor easy to use benchmarking systems of the present invention into which an employer can input data on multiple units and quickly develop an easy-to-read online quantitative report comparing the individual units to each other, or the company to national averages. Neither do they provide recommendations for improvement informing companies what changes that need to be made.
The data benchmarking and assessment methods of the present invention allow management to make quick, informed decisions based on the quantifiable indices produced by the methods. The methods allow a multi-site employer to assess workers' compensation performance in many locations simultaneously for review by management. Brokers, insurance companies and third party administrators may use the methods of the present invention to assess their multi-unit clients' best practices performance. This assessment can take place within a few minutes utilizing the methods of the present invention, compared to weeks and months using the standard method in the industry of hiring a consultant for on-site reviews and training, usually one site at a time.
An additional advantage of the method of the present invention is to educate the user about the various methods of workers' compensation cost containment and best practices across more than one company unit. The methodology is designed to be informative and may be completed with a group of representatives from more than one company unit to provoke discussion. The educational content requests company information on the numerous variables and thereby starts educating the user immediately with the first section of the Best Practice Assessment.
A further advantage of the method of the present invention is an automated injury management program that is employer driven. Because the assessment is web-based and completely automated this is a departure from the traditional and conventional method of the industry of assessing workers' compensation issues across multiple units of a company.
A further advantage of the methods of the present invention is that assessment results are numeric and quantifiable for each user, company unit, a plurality or group of company units, or the company as a whole.
A further advantage of the methods of the present invention is that the data benchmarking and assessment methods maintain measurements of analyzed data so that evaluations are uniform across multiple units. Thus a company having multiple units can assure that evaluations are consistent from unit to unit and can discern patterns, trends, variations, and other differences or similarities between units, groups or within the company as a whole.
A further advantage of the method of the present invention is that money for implementation of recommendations may be informatively allocated by management based upon the analyzed data. Thus the methods of the present invention may change the direction and apportionment of program costs for multiple units within a company. Instead of investing heavily in funding an expensive consultant mediated assessment and recommendation process for multiple company units, individual company units representatives complete these steps inexpensively online thereby saving money for the more critical portion of workers' compensation cost management, Implementation of Recommendations, which is where company resources should preferably be allocated to maximize program results.
A further advantage of the method of the present invention is that since participants tend to lose focus when a process is stretched over a long period of time, as with the current methods described in the prior art, shortening the process for multiple units by the method of the present invention sustains focus and intent to implementation. Shortened assessment recommendation time frames sustain user focus in implementation, and shortened time frames sustain project momentum onto and through completion.
A further advantage of the method of the present invention is that based on the National Workers' Compensation Management Score®, users in each unit can gauge how well or how poorly they are doing, and will quickly have an idea of their strengths and weaknesses. The Recommendations will provide the basis for an action plan for that specific company unit. Thus, before the end of a business day, users can have the nucleus of an implementation plan to use going forward.
A further advantage of the method of the present invention is that before the method of the present invention, only the largest companies could avail themselves of a workers' compensation management program because the program was paper based and consultants were needed to conduct the assessments and training. Whereas with the method of the present invention the methods of the program are employer driven. An employer representative, such as the company workers' compensation program manager, can direct individual units to participate in the assessment. From those unit assessments, the program manager may determine the effectiveness of the implementation of program recommendations and then determine where any additional improvements need to be made in each participating unit, across multiple company units, or the entire company.
A further advantage of the method of the present invention is that the methodology is quantifiable in individual company units, a plurality or group of units, or the company as a whole. Before, assessments could only be couched in terms of words. By the methods of the present invention users obtain a workers' compensation score that quantifies their performance in preferably the ten major key economic drivers that comprise workers' compensation costs. Quantifying assessment data has huge ramifications for discerning economic or geographical trends by management, or detecting trends in specific types of businesses i.e., manufacturing, service industries. Quantifying assessment data also enables users to forecast the depth and breadth of their individual unit injury management program. The higher the score, the smaller the implementation process required, the lower the score, the more implementation areas need to be activated.
A further advantage of the method of the present invention is the adaptability for multi divisional companies. The methods of the present invention provide uniformity in assessment simultaneously across multiple company units never before possible. In the past, assessing workers' compensation practices for multi-divisional companies was an almost Herculean task, and assessment alone could take years. And even then it would not present a complete picture as assessment criteria might differ between units, or owners might opt not to assess every facility due to the time and cost involved. The method of the present invention enables employers to have every division participate in the same assessment for a significantly lower cost than the prior on site methods in the art measuring the same criteria. Automation of the analysis provides results rapidly which provides a great advantage for management conducting a comprehensive assessment of global proportions, and doing so with relative ease. Thus the online system enables designated managers to view subordinate divisions and determine areas for improvement and make comparisons between units. The fact that every unit takes the same assessment and the answers are standardized ensures that the measurement is a universal comparative yardstick, or score, upon which the key cost drivers can be measured from unit to unit. Thus the score ensures that every participant is being measured on consistent rather than arbitrary criteria.
In yet another aspect of the invention, if a multiple unit company, has their own set of unique workers' compensation performance standards to be used in their assessments and benchmarking, the company representative may have a custom database compiled and made available via the methods of the present invention. Each internet application web menu may be created and customized specifically for a multiple unit company user. The user will then direct each of its representatives, as well as its independent contractors or consultants, to the one location on the internet where the program standards can be obtained and used to manage the program. The application provides an internet based set of tools and menus that advance and enhance the environment for the specific needs of the multiple unit company user and are instantly available to a representative with an internet connection.
This listing of the several advantages of the present invention is not intended to be all-inclusive and many other advantages will be made apparent by the following detailed description.